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STATEMENT OF BUILDER - Florida Department of Highway ...

2. List the major component parts used in the building/repair process (if additional space is needed, please use form HSMV 84491). Part. New Used Repaired Aftermarket Homemade Source/VIN . 3. When Section II (1) is not applicable, describe the repairs made in detail. (If additional space is needed, please use form HSMV 84491.

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